Signal of Interest Selection Standard for Ultrasonic Backscatter in Cancellous Bone Evaluation

The aim of this study was to examine the effect of the backscattered signal of interest (SOI) on ultrasonic cancellous bone evaluation. In vitro backscatter measurements were performed using 16 bovine cancellous bone specimens and six different transducers with central frequencies of 0.5, 1, 2.25, 3.5, 5 and 10 MHz. The SOI for signal analysis was selected by a rectangular window. The delay (T1) and duration (T2) of the time window were varied, and the apparent integrated backscatter (AIB) and its correlation to bone volume fraction (BV/TV) were calculated. The results indicate that in addition to affecting the measured value of AIB, the SOI influences the observed correlation between AIB and BV/TV. Strong positive correlations were observed for short T1 (0.5 MHz: ≤6 μs, 1 MHz: ≤3 μs, 2.25 and 3.5 MHz: ≤2 μs, 5 and 10 MHz: ≤1 μs). However, strong negative correlations were observed when T1 was long (0.5 MHz: >9 μs, 1 MHz: >7 μs, 2.25 and 3.5 MHz: >3 μs, 5 and 10 MHz: >2 μs). The T2 value, especially low values (≤3 μs), also influenced the correlation coefficients. Positive correlations were more commonly observed at lower frequencies (i.e., 0.5–1 MHz), whereas negative correlations were more common at higher frequencies (i.e., 2.25–10 MHz). An explicit standard for in vitro SOI selection and cancellous bone assessment was proposed for a broad frequency range (0.5–10 MHz). Current conflicting findings are explained, and constructive suggestions for ultrasonic backscatter cancellous bone evaluation are provided.     

Assessment of urinary bone markers for monitoring treatment of osteoporosis

BACKGROUND: The usefulness of urinary markers of bone turnover in monitoring therapy depends on their within-person variability compared with their responses to therapy. The aim of this study was to assess the performance of two such markers on this basis. METHODS: We measured variation, during a whole year, of cross-linked N-terminal telopeptide of collagen I (NTx) and urinary deoxypyridinoline (DPD) as ratios to creatinine concentration and after log-transformation of the ratios in untreated women stratified into three bone density classes, of which the lowest was osteoporotic. We also measured changes in bone mineral density at the lumbar spine (LSBMD) and hip (FNBMD) in untreated women with normal bones and in those with moderate osteopenia and calculated the reference change value (RCV; or least significant change) at P <0.05 for all of these measures. We made the same measurements on women treated with bisphosphonates, estrogen replacement (HRT), or calcium and examined their individual responses to treatment compared with RCV. RESULTS: After 12 months on bisphosphonates, LSBMD changed more than RCV (2.55%) in 47% of women compared with 44% of those on HRT and 13% of those on calcium. Response of FNBMD was less. Log NTx (RCV= -28%) responded to bisphosphonates in 78%, regardless of BMD, but less often to HRT (67%). Log DPD (RCV= -30%) responded to bisphosphonates less frequently (31% at 12 months). CONCLUSIONS: NTx has advantages over DPD in monitoring therapy for osteoporosis when mailed urine samples are used.     

Dual-energy digital radiography in the assessment of bone mechanical properties

At present, bone fragility and fracture risk are estimated with bone mineral density (BMD), measured by dual-energy x-ray absorptiometry (DXA). It is known that DXA-based BMD (BMD(DXA)) has a relationship with mechanical characteristics of bone. Dual-energy digital radiography (DEDR) has also been shown to be a potential method to determine BMD, but the ability of DEDR-based BMD (BMD(DEDR)) to predict bone mechanical properties is not yet known. In this study, we investigated the ability of BMD(DEDR) to predict the mechanical characteristics of bone. Reindeer femora (N = 50) were imaged at two different energies (79 and 100 kV(p)) using a clinical digital radiography system. BMD was determined in four regions from these images using the DXA calculation principle. Femora were mechanically tested using axial loading configuration. Mechanical parameters were correlated with the BMD(DEDR) and BMD(DXA) of the femoral neck (FNBMD(DEDR) and FNBMD(DXA)). FNBMD(DEDR) and FNBMD(DXA) both correlated moderately with mechanical parameters. The highest correlations were found with maximal load (r = 0.53 and r = 0.65, p < 0.01, respectively). No statistically significant differences were found between the correlation coefficients when comparing the FNBMD(DEDR) or FNBMD(DXA) values and mechanical parameters. The correlation coefficient between BMD(DEDR) and BMD(DXA) varied between r = 0.56 and 0.86 (p < 0.01) in different regions of the upper femur. In conclusion, BMD(DEDR) predicts the mechanical parameters of reindeer bone with similar accuracy as BMD(DXA).     

The correlation between scapulocostal syndrome and masticatory myofascial pain on selected pain and functional parameters- an observational study

ObjectivesAlthough scapulocostal syndrome (SCS) and masticatory myofascial pain (MMP) occur in different regions, the concept of myofascial linkage and neurophysiology may be proven per the connection of the two disorders. Therefore, this study aimed to investigate the correlation between SCS and MMP on selected pain and functional parameters.Method75 participants with SCS participated in the protocol. The diagnosis of SCS was considered by the presence of muscle referred pain in the medial scapular muscles. All participants were measured for pain intensity, pressure pain threshold (PPT), and craniovertebral angle (CV-angle) for pain and functional parameters related to SCS. They were measured for pain intensity, PPT, and mouth distance for the pain and functional parameters related to MMP. The diagnosis of MMP was considered by the presence of muscle tenderness of the masticatory muscle and the decreasing of mouth opening distance. The correlation between SCS and MMP was determined using Pearson's correlation coefficient and Spearman's correlation.ResultsParticipants exhibiting SCS were diagnosed for MMP at 74.67%. The results showed positive correlations in pain intensity and PPT between SCS and MMP (r = 0.367, r = 0.478, p < 0.01), PPT of SCS, and mouth distance amid both pain-free and maximum mouth opening conditions, respectively (r = 0.290, r = 0.282, p < 0.05).ConclusionIn conclusion, SCS and MMP present an association with each other in terms of both selected pain, and functional parameters. Thus, a treatment program for SCS patients should be concerned with the masticatory muscles even if they did not report any pain at the jaw area.     

老年男性吸烟与骨转换标志物、骨密度和骨质疏松性骨折风险的关系

目的 调查老年男性吸烟与骨转换标志物、骨密度和骨质疏松性骨折风险的关系.方法 调查576例60～97岁老年男性吸烟等情况,按照是否吸烟分成吸烟组31例和非吸烟组545例.检测两组骨转换标志物[包括I型胶原羧基末端肽交联(CTX)、I型前胶原氨基端前肽(P1NP)和骨钙素(OC)]、骨密度[包括股骨颈骨密度(FNBMD)...     

Statistical model based analysis of bone mineral density of lumbar spine

Objective  For planning surgical interventions at the spine affected by osteoporosis, accurate information about the local bone quality in terms of anchorage strength for implants is very important. Based on previous work on automated bone quality assessment on the proximal femur with a completely automated model-based approach, this paper describes first applications and results on the lumbar vertebrae. Materials and methods  As basis for the analysis, CT datasets of 17 spinal specimens, with a resolution of 0.7 mm × 0.7 mm × 0.7 mm have been used. A combined statistical model of 3D shape and intensity value distribution was created for these datasets and used to predict the measured bone mineral density (BMD). Different regions of interest were tested, model parameters with high correlation with BMD were identified. Leave-one-out tests were performed to evaluate the capability for the BMD-prediction using regression models. Results  High correlation values (R = 0.94) between measured and predicted BMD were achieved and the high predictive quality of the model could be shown. Conclusion  Although the results are only valid for an insufficient small sample size of specimen data, they show a clear potential for clinical application. Therefore, work in the future will focus on clinical validation with larger sample size and the inclusion of biomechanical properties in addition to BMD.     

Risk for Osteoporosis in Elderly Nuns: Need for Better Recognition and Treatment

Background: The risk for osteoporosis in Catholic sisters (nuns) may be even higher than that of the general female population given their longer life expectancy (82.0 to 89.0 years vs 79.6 years for the average white woman) and the use of a traditional habit as a young adult, resulting in limited sun exposure (ie, exposure to vitamin D).Objectives: The aim of this study was to determine, in a group of elderly nuns attending an annual health screening day (Health Forum), how many met National Osteoporosis Foundation (NOF) treatment criteria using peripheral bone mineral density (BMD) measurements and risk factors; what proportion received adequate vitamin D; whether BMD was related to length of time that nuns wore a habit; and whether BMD measurement led to medical interventions. In addition, we compared the usefulness of calcaneal BMD with that of BMD at central sites for identification of those at risk for osteoporosis.Methods: This cross-sectional study assessed BMD by calcaneal dual energy X-ray absorptiometry (DXA) and, for some participants, central DXA. A baseline questionnaire and follow-up mail survey also were included.Results: Of the 230 nuns attending the Health Forum, 146 (63%) (mean age, 70 years; range, 48-90 years) participated in the study. Of these, 14% had calcaneal osteoporosis (T-score <−2.5) and 32% met NOF treatment criteria, indicating risk comparable to that of other postmenopausal American women. Sixty-four percent were receiving less than the recommended amount of vitamin D (≥400 IU/d for those aged <71 years and ≥600 IU/d for those aged ≥71 years). Calcaneal BMD was inversely related to the length of time nuns had worn a habit. Fifty-six women subsequently underwent central DXA. Using a calcaneal T-score of −1.2 to identify those with central osteoporosis, sensitivity and specificity of 78% and 76%, respectively, were obtained. According to the mail survey, 11 of 42 respondents who had met NOF treatment criteria started new medications for osteoporosis.Conclusions: Elderly nuns are at substantial risk for osteoporosis. Most receive inadequate vitamin D. For nuns and others who may have limited access to central DXA measurement, peripheral measurements may help identify those in need of further intervention. Further efforts, in addition to BMD measurements, are necessary to ensure appropriate therapy for those who meet treatment criteria.     

Bone mineral density in patients with stroke

The objectives of this study were to investigate the development and pathogenesis of osteoporosis in stroke in-patients, to compare the bone mineral density (BMD) of the paretic and non-paretic sides, to study longitudinal changes during the period on the rehabilitation ward and to relate BMD to demographic, impairment and disability variables. Participants were 32 first-stroke in-patients (19 men), with an average age of 62.4 +/- 8.1 years. Demographic and clinical characteristics were documented. The BMD of lumbar spine, bilateral distal radius and femoral neck were measured and compared at admission and discharge. The associations between bone loss and age, sex, time since stroke, Brunnstrom motor recovery scores and functional independence measure motor (mFIM) scores were assessed. The mean percentage differences in BMD between paretic and non-paretic arms at discharge were 12% (P < 0.001) and 3.5% (P < 0.05), respectively, and between paretic and non-paretic legs were 5% (P < 0.01) and 2% (P < 0.05), respectively. There was a statistically significant correlation between BMD loss and Brunnstrom stage (r = -0.41) and mFIM score at admission (r = -0.42). In conclusion, patients with hemiparesis due to stroke are at increased risk of developing osteoporosis on the paretic side. Higher motor impairment and functional dependency at admission increases the risk. New strategies are needed for stroke patients to prevent further decreases in BMD and reduce the risk of fractures.     

Association between mean platelet volume and bone mineral density in patients with ankylosing spondylitis and diagnostic value of diffusion-weighted magnetic resonance imaging

[Purpose] The aim this study was to assess the relation between bone mineral density (BMD) and mean platelet volume (MPV) in ankylosing spondylitis (AS) patients, and evaluate the diagnostic role of the diffusion-weighted magnetic resonance imaging (MRI). [Subjects and Methods] Fifty patients diagnosed with AS were divided into two groups on the basis of BMD, a normal group (n=30) and an osteopenic (n=20) group. [Results] Duration of disease in the group with a normal BMD was 10.3±7.0 years, while it was 16.7±12.2 years in the osteopenia group. MPV was high in the osteopenia group, while no significant differences were observed between the groups in terms of apparent diffusion coefficient (ADC) and platelet distribution width (PDW). There was a positive correlation between MPV and duration of disease. Correlations between ADC value and the lumbar T score, femoral neck T score, and duration of disease were insignificant. A negative correlation was observed between BMD and disease duration. [Conclusion] Diffusion-weighted imaging provides valuable results in osteoporosis but is not a suitable technique for evaluating BMD in patients with AS because of the local and systemic inflammatory effects in the musculoskeletal system. The common pathophysiology of atherosclerosis and osteoporosis plays an important role in the negative correlation observed between MPV and BMD in patients with AS.Key words: Ankylosing spondylitis, Bone mineral density, Mean platelet volume     

Clinical Utility of Ultrasound-Guided Attenuation Parameter for the Detection and Quantification of Hepatic Steatosis in Patients with Fatty Liver Diagnosed by Computed Tomography

This retrospective study was aimed (i) at elucidating the correlation between fatty liver diagnoses based on the plain computed tomography (CT) value and those based on the attenuation coefficient (AC) value determined with the ultrasound-guided attenuation parameter (UGAP) and (ii) at evaluating the diagnostic power of AC values. We included 125 patients who underwent blood tests, abdominal ultrasonography and abdominal CT at our department between April 2020 and March 2021. Hepatic fat infiltration was categorized as S0 (<5%), S1 (≥5 and 30<%), S2 (≥30 and <50%) or S3 (≥50%). The diagnostic ability of UGAP-determined AC was evaluated using receiver operating characteristic (ROC) curve analysis, and the correlation between AC value and fatty liver grade by CT value. The coefficient of correlation (r) between the AC value and plain CT value was –0.6188, indicating a moderate relationship. For diagnosing grade ≥S1 (n = 44), the area under the ROC curve (AUROC) was 0.8541, sensitivity 84.1%, specificity 81.5% and cutoff value 0.676 dB/cm/MHz. In diagnosing grade ≥S2 (n = 35), the AUROC was 0.8603, sensitivity 88.6%, specificity 81.1% and cutoff value 0.694 dB/cm/MHz. In diagnosing grade = S3 (n = 18), the AUROC was 0.9016, sensitivity 94.5%, specificity 81.9% and cutoff value, 0.704 dB/cm/MHz. The AC value is useful in diagnosing fatty liver.     

Meshless Bubble Filter Using Ultrasound for Extracorporeal Circulation and its Effect on Blood

A bubble filter with no mesh structure for extracorporeal circulation using ultrasound was developed. Hemolysis was evaluated by measuring free hemoglobin (FHb). FHb in 120 mL of bovine blood was measured in acoustic standing-wave fields. With a sound pressure amplitude of 60 kPa at driving frequencies of 1 MHz, 500 kHz and 27 kHz for 15 min. FHb values were 641.6, 2575 and 8903 mg/dL, respectively. Thus, hemolysis was inhibited with higher driving frequencies when the same sound pressure amplitude was applied. An ultrasound bubble filter with a resonance frequency of 1 MHz was designed. The filtering characteristics of the flowing microbubbles were investigated with a circulation system using bovine blood with a flow rate of 5.0 L/min. Approximately 99.1% of microbubbles were filtered with 250 kPa and a flow of 5.0 L/min. Hemolysis decreased as the sound pressure decreased; FHb values were 225.8 and 490.7 mg/dL when using 150 and 200 kPa, respectively.     

Clinical Assessment of the 1/3 Radius Using a New Desktop Ultrasonic Bone Densitometer

The objectives of this study were to evaluate the capability of a novel ultrasound device to clinically estimate bone mineral density (BMD) at the 1/3 radius. The device rests on a desktop and is portable, and permits real-time evaluation of the radial BMD. The device measures two net time delay (NTD) parameters, NTD_DW and NTD_CW. NTD_DW is defined as the difference between the transit time of an ultrasound pulse to travel through soft-tissue, cortex and medullary cavity, and the transit time through soft tissue only of equal overall distance. NTD_CW is defined as the difference between the transit time of an ultrasound pulse to travel through soft-tissue and cortex only, and the transit time through soft tissue only again of equal overall distance. The square root of the product of these two parameters is a measure of the radial BMD at the 1/3 location as measured by dual-energy X-ray absorptiometry (DXA). A clinical IRB-approved study measured ultrasonically 60 adults at the 1/3 radius. BMD was also measured at the same anatomic site and time using DXA. A linear regression using NTD produced a linear correlation coefficient of 0.93 (p < 0.001). These results are consistent with previously reported simulation and in vitro studies. In conclusion, although X-ray methods are effective in bone mass assessment, osteoporosis remains one of the largest undiagnosed and under-diagnosed diseases in the world today. The research described here should enable significant expansion of diagnosis and monitoring of osteoporosis through a desktop device that ultrasonically assesses bone mass at the 1/3 radius.     

Feasibility of Bone Assessment with Ultrasonic Backscatter Signals in Neonates

The objective of this study was to assess the value of ultrasonic backscatter signals and the backscatter coefficient (BSC) in the analysis of bone status in neonates and to analyze the relationships between the BSC and gestational age, birth weight, length, head circumference and gender. A total of 122 neonates participated in the study, including 83 premature infants and 39 full-term infants. Their BSCs were measured by ultrasound after birth. The results revealed a significant correlation between the BSC and gestational age (R = 0.47, p < 0.001), birth weight (R = 0.47, p < 0.0001) and length at birth (R = 0.43, p < 0.001) at a frequency of 5.0 MHz. This study suggests that the use of ultrasonic backscattering and the BSC is feasible for assessment of the bone status of neonates.     

Performance of Phalangeal Quantitative Ultrasound Parameters in the Evaluation of Reduced Bone Mineral Density Assessed By DX in Patients with 21 Hydroxylase Deficiency

The purpose of this study was to verify the performance of quantitative ultrasound (QUS) parameters of proximal phalanges in the evaluation of reduced bone mineral density (BMD) in patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency (21 OHD). Seventy patients with 21 OHD (41 females and 29 males), aged between 6–27 y were assessed. The QUS measurements, amplitude-dependent speed of sound (AD-SoS), bone transmission time (BTT), and ultrasound bone profile index (UBPI) were obtained using the BMD Sonic device (IGEA, Carpi, Italy) on the last four proximal phalanges in the non-dominant hand. BMD was determined by dual energy X-ray (DXA) across the total body and lumbar spine (LS). Total body and LS BMD were positively correlated to UBPI, BTT and AD-SoS (correlation coefficients ranged from 0.59–0.72, p < 0.001). In contrast, when comparing patients with normal and low (Z-score < −2) BMD, no differences were found in the QUS parameters. Furthermore, UBPI, BTT and AD-SoS measurements were not effective for diagnosing patients with reduced BMD by receiver operator characteristic curve parameters. Although the AD-SoS, BTT and UBPI showed significant correlations with the data obtained by DXA, they were not effective for diagnosing reduced bone mass in patients with 21 OHD.     

Dual-frequency ultrasound--new pulse-echo technique for bone densitometry

Quantitative ultrasound has been suggested for screening of osteoporosis. Most commercial ultrasound devices are based on the through-transmission measurement of calcaneus, which is not a typical fracture site. In contrast to through-transmission measurements, reflection and backscattering measurements may be conducted at typical fracture sites such as vertebra and proximal femur. At these regions, soft tissues overlying bones affect reliability of the measurements. In this study, a novel dual-frequency ultrasound (DFUS) pulse-echo technique is introduced for reduction of the errors induced by soft tissues. First, DFUS was validated using elastomer samples. For further validation, human trabecular bone samples (n = 25) covered with heterogeneous soft tissues were measured at frequencies of 2.25 MHz and 5.0 MHz. The DFUS technique reduced (p < 0.01) the mean error induced by soft tissue from 58.6% to -4.9% and from 127.4% to 23.8% in broadband ultrasound backscattering and integrated reflection coefficient (at 5.0 MHz), respectively. To conclude, the DFUS, being the first ultrasound technique capable of determination of the composition and thickness of the soft tissue overlying the bone, may enhance the accuracy of clinical ultrasound measurements. Thereby, DFUS shows a significant clinical potential.     

Characterization of Thyroid Cancer in Mouse Models Using High-Frequency Quantitative Ultrasound Techniques

Currently, the evaluation of thyroid cancer relies on the use of fine-needle aspiration biopsy, as non-invasive imaging methods do not provide sufficient levels of accuracy for the diagnosis of this disease. In this study, the potential of quantitative ultrasound methods for characterization of thyroid tissues was studied using a rodent model ex vivo. A high-frequency ultrasonic scanning system (40 MHz) was used to scan thyroids extracted from mice that had spontaneously developed thyroid lesions (cancerous or benign). Three sets of mice were acquired having different predispositions to developing three thyroid anomalies: C-cell adenoma, papillary thyroid carcinoma (PTC) and follicular variant papillary thyroid carcinoma (FV-PTC). A fourth set of mice that did not develop thyroid anomalies (normal mice) were used as controls. The backscatter coefficient was estimated from excised thyroid lobes the different mice. From the backscatter coefficient versus frequency (25–45 MHz), the effective scatterer diameter (ESD) and effective acoustic concentration (EAC) were estimated. From the envelope of the backscattered signal, the homodyned K distribution was used to estimate the k parameter (ratio of coherent to incoherent signal energy) and the μ parameter (number of scatterers per resolution cell). Statistically significant differences were observed between cancerous thyroids and normal thyroids based on the ESD, EAC and μ parameters. The mean ESD values were 18.0 ± 0.92, 15.9 ± 0.81 and 21.5 ± 1.80 μm for the PTC, FV-PTC and normal thyroids, respectively. The mean EAC values were 59.4 ± 1.74, 62.7 ± 1.61 and 52.9 ± 3.42 dB (mm⁻³) for the PTC, FV-PTC and normal thyroids, respectively. The mean μ values were 2.55 ± 0.37, 2.59 ± 0.43 and 1.56 ± 0.99 for the PTC, FV-PTC and normal thyroids, respectively. Statistically significant differences were observed between cancerous thyroids and C-cell adenomas based on the ESD and EAC parameters, with an estimated ESD value of 21.3 ± 1.50 μm and EAC value of 54.7 ± 2.24 dB mm⁻³ for C-cell adenomas. These results suggest that high-frequency quantitative ultrasound may enhance the ability to detect and classify diseased thyroid tissues.     

In Vivo Comparison of Backscatter Techniques for Ultrasonic Bone Assessment at the Femoral Neck

Ultrasonic techniques are being developed to detect changes in cancellous bone caused by osteoporosis. The goal of this study was to test the relative in vivo performance of eight backscatter parameters developed over the last several years for ultrasonic bone assessment: apparent integrated backscatter (AIB), frequency slope of apparent backscatter (FSAB), frequency intercept of apparent backscatter (FIAB), normalized mean of the backscatter difference (nMBD), normalized slope of the backscatter difference (nSBD), normalized intercept of the backscatter difference (nIBD), normalized backscatter amplitude ratio (nBAR) and backscatter amplitude decay constant (BADC). Backscatter measurements were performed on the left and right femoral necks of 80 adult volunteers (age = 25 ± 11 y) using an imaging system equipped with a convex array transducer. For comparison, additional ultrasonic measurements were performed at the left and right heel using a commercially available heel-bone ultrasonometer that measured the stiffness index. Six of the eight backscatter parameters (all but nSBD and nIBD) exhibited similar and highly significant (p < 0.000001) left–right correlations (0.51 ≤ R ≤ 0.68), indicating sensitivity to naturally occurring variations in bone tissue. Left–right correlations for the stiffness index measured at the heel (R = 0.75) were not significantly better than those produced by AIB, FSAB and FIAB. The short-term precisions of AIB, nMBD, nBAR and BADC (7.8%–11.7%) were comparable to that of the stiffness index measured with the heel-bone ultrasonometer (7.5%).     

Collagen and Chondrocyte Concentrations Control Ultrasound Scattering in Agarose Scaffolds

Ultrasound imaging has been proposed for diagnostics of osteoarthritis and cartilage injuries in vivo. However, the specific contribution of chondrocytes and collagen to ultrasound scattering in articular cartilage has not been systematically studied. We investigated the role of these tissue structures by measuring ultrasound scattering in agarose scaffolds with varying collagen and chondrocyte concentrations. Ultrasound catheters with center frequencies of 9 MHz (7.1–11.0 MHz, −6 dB) and 40 MHz (30.1–45.3 MHz, −6 dB) were applied using an intravascular ultrasound device. Ultrasound backscattering quantified in a region of interest starting right below sample surface differed significantly (p < 0.05) with the concentrations of collagen and chondrocytes. An ultrasound frequency of 40 MHz, as compared with 9 MHz, was more sensitive to variations in collagen and chondrocyte concentrations. The present findings may improve diagnostic interpretation of arthroscopic ultrasound imaging and provide information necessary for development of models describing ultrasound propagation within cartilage.     

The circulating concentration and ratio of total and high molecular weight adiponectin in post-menopausal women with and without osteoporosis and its association with body mass index and biochemical markers of bone metabolism

ObjectivesThere is increasing evidence suggesting that adiponectin plays a role in the regulation of bone metabolism.Design and methodsThis was a cross-sectional study of 34 post-menopausal women with and 37 without osteoporosis. All subjects had body mass index (BMI), bone mineral density (BMD), total-, high molecular weight (HMW)-adiponectin and their ratio, osteoprotegerin (OPG), a marker of bone resorption (βCTX) and formation (P1NP) measured.ResultsWe observed a positive correlation between BMI and BMD (r = 0.44, p < 0.001). When normalised for BMI, total-, HMW-adiponectin concentrations and HMW/total-adiponectin ratio were significantly lower in obese compared to lean subjects but there was no difference between those with or without osteoporosis. There were significant negative correlations between HMW/total-adiponectin ratio and BMI (r = ? 0.27, p = 0.030) and with OPG (r = ? 0.44, p < 0.001).ConclusionsOur data suggests that there is no significant difference in the circulating concentration of fasting early morning total- or HMW-adiponectin in post-menopausal women with or without osteoporosis. The correlation between HMW/total-adiponectin ratio and OPG may indicate that adiponectin could influence bone metabolism by altering osteoblast production of OPG thereby affecting osteoclasts mediated bone resorption.     

The shape of anterior-posterior spinal curvature in post-menopausal women with osteoporosis

Background. The co-occurrence of kyphotic posture and low bone density in elderly women has never been completely explained. The aim of our study was to assess postural changes (the shape of spinal curvatures) in elderly women with advanced spinal osteoporosis. Material and methods. We examined 62 women (32 with osteoporosis and 30 with normal BMD) 52 to 84 years of age. The photogrammetric method based on the moiré phenomenon was used to measure the spinal contour (kyphosis and lordosis), and DEXA was employed to assess bone mineral density (BMD) at the lumbar spine level. Results. The group with osteoporosis had significantly greater kyphosis (p<0.05) than the group without osteoporosis; however, we found a correlation between the BMD and the parameters of the spinal contour. In the group of women with osteoporosis, the BMI was significantly correlated with the lumbar lordosis angle (p<0.01), the compensation index (p<0.01), and the BMD (p<0.01), and it was also highly correlated with the inclination angle of the lumbosacral spinal segment (p<0.001). Another significant correlation occurred between the lumbosacral spinal segment inclination angle and height loss (p<0.05). A weak correlation was observed between age and the inclination angle of the upper thoracic spinal segment (p<0.05). Conclusion. The observed changes in body posture in women with osteoporosis result primarily from enlargement of the upper section of thoracic kyphosis.